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Group Health & Benefits • Compliance • HR

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ACA/ObamaCare – For Small Businesses

There have been many changes to the Affordable Care Act (ACA), or ObamaCare. Groups with over 50 employees have to comply with the Employer Mandate which requires them to offer health insurance to their full-time workers.

Tax Credits

If you are a small employer, you MAY be able eligible for tax credits from the government of up to 50% of the health insurance premiums paid by the employer.  We always recommend researching with your CPA to see if you qualify as a business.  The health insurance plans have to be purchased through the SHOP program at Covered CA to be eligible for the credit.  Hey…it’s worth exploring.

Health Reform Compliance

ALL employers must have specific compliance paperwork filed and archived in case of an IRS or the Department of Labor audit, (SEE BELOW). The paperwork is easy to put together; if you need help or more information, give us a call.

For larger employers, the most important new requirement of health reform is the Employer Mandate, that requires all employers with more than 50 full-time employees (or full-time-equivalent employees) to offer affordable, minimum health coverage to all full-time employees, or else pay a potentially hefty penalty.

Employee Benefits

Employee Benefits for employers should not cost you a fortune. Brauer Insurance can help you strategize the Employee Benefits that will help you attract and retain good employees. Whether its Group Health Insurance, Group Dental Insurance, Vision, or other key benefits, we can help you maximize your dollars. If you view Employee Benefits as an investment, it becomes a different conversation. With benefits being just under wages for the most expensive item for companies, a good strategy and partner is essential. For Group Employee Benefits and Employee Health Benefits we offer a wide range of value added FREE services that most brokers don’t have:

  • COBRA Administration, we assist in the compliance notifications for incoming and outgoing employees to relieve you of the liability
  • In-house HR Attorney, to help groups with employment issues that arise
  • Online HR Platform

Group Health Insurance

Group Employee Health Insurance is the most popular choice among employers. While group employee health insurance plans are typically expensive, we can help you maximize what you spend on your Group Health Insurance.  We can provide you with many testimonials from companies that have been wildly successful using our strategy for group employee health insurance.

Group Health Plans

Group Health Plans are usually structured in one of several ways:

  • PPO (Preferred Provider Organization) PPOs are well suited for employees who want the freedom to choose their own doctor. As a PPO subscriber, you have the choice of using either an “in-network” or “out of network” doctor. By staying in the network, you receive the biggest benefit, lower copays and less out of pocket costs. PPOs are typically less expensive than HMOs.
  • EPO (Exclusive Provider Organization)  EPOs have come into the market recently offering better pricing, but there are some drawbacks.  With EPOs, there is no out of network benefits, which can limit people in their choices.  The cost savings is typically 5-10% over a more robust PPO network.
  • HMO (Health Maintenance Organization) HMOs are designed in such a way that employees are restricted to HMO doctors and hospitals only, except for emergency services. HMO copays are usually lower but the monthly cost is usually much higher. Kaiser is one of the more popular HMO type platforms.
  • HSA (Health Savings Account) HSAs are usually PPO type plans with an HSA component attached. The HSA part is a tax free savings account, sometimes referred to as a “medical IRA”. The HSA allows the employees to have a savings account to pay for qualified Employee Benefit out of pocket expenses on a tax free basis. The HSA account can be funded by the company, the employee themselves, or anyone. Contributions are limited to $3450 for singles and $6900 for families. Money not used by the end of the year “rolls over” year to year with no limits. This tax free money can be used for things like; Dental expenses, Vision, Chiropractic, Massage, Acupuncture, Orthodontics, prescribed medications, etc.
  • HRA (Health Reimbursement Arrangement) HRAs are very similar to HSAs. The biggest difference with an HRA is that when an employee has a medical expense, they are “reimbursed” by the employer. HRA Health Plans are very flexible and the benefit structure can be tailored to the needs of each company. The pricing of HRAs vary widely.

Other Popular Employee Benefits

  • Group Dental Insurance. Group Dental can vary widely in coverage and cost. Many plans have no waiting periods to obtain services, large networks, and have at least $1500 or $2000 in yearly benefit, per person. Some of the top companies include: Delta Dental, MetLife, Guardian, Principal, Humana, United HealthCare, Aetna, Cigna, Blue Shield. A Group Dental plan ranges from about $40-$80 a month.
  • Group Vision Insurance. Vision coverage varies widely but is relatively inexpensive. VSP and EyeMed are probably the most popular companies. We usually recommend the Vision benefit allow for lenses, frames, and exams every months. Pricing ranges from $9-$15 a month.
  • Group Disability Insurance. Disability coverage is purchased for protection in case an employee gets injured and is unable to work. The disability can be either classified as Short Term Disability or Long Term Disability. The coverage is based on the employees income, the benefit payout, and the “waiting period” before benefits start. The coverage can be structured to include both on and off the job injuries.
  • Voluntary Benefits, Gap Insurance.  This insurance is typically associated with companies like AFLAC, Colonial, American Fidelity, and others.  When you have “accidents” or hospital stays, they will pay you money, to help cover expenses.  They will pay amounts starting at $500-$10,000 per employee, depending on the coverage.

Employers are always looking for ways to attract and retain good people. And while a poorly planned employee health insurance plan can be expensive, we get you the most effective plan for your money.

Medicare Supplement/MediGap Plans

Medicare Part A (Hospital Coverage) pays for inpatient hospital services, skilled nursing facility care after a hospital stay, home health care, and hospice care.  Medicare Part A also pays for all but the first three pints of blood each calendar year.

Medicare Part B (Medical Coverage) pays for medical expenses, clinical laboratory services, and outpatient hospital treatment.  In most cases, Medicare pays 80% of the Medicare-approved cost of covered medical expenses, including physicians’ services and supplies.  Some Medicare Part B services are paid as a specified fixed payment.

Medicare also pays for preventive health services including: exams, lab tests, health screenings, and shots.

Medicare Part D (Prescription Drug Coverage) pays for generic and brand-name prescription drugs.  You can receive prescription drug coverage by joining a stand-alone prescription drug plan or by purchasing a Medicare Advantage plan that includes the coverage.  

Medicare Supplement/MediGap Policy

A supplemental policy is structured to fill the “gaps” in original Medicare Part B plan coverage.  These policies help pay some of the health care costs the Medicare does not cover.

There are many MediGap plans available.  The most commonly purchased plan is plan F, which has a variety of features that are popular.

When you purchase a Medicare Supplement policy, you must have Medicare Part A and Part B.  You and your spouse must EACH buy separate Supplement plans.  Your policy WILL NOT cover any health care costs for your spouse.

We specialize in Group Health Insurance and Group Employee Benefits

We are a NO FEE, independent, family run agency

We protect and serve small business with 1-100 employees anywhere in CA.  We are recognized experts on ACA/Obama Care. We focus ONLY on Group Health Insurance. We match your business needs with your budget. We strategize the best coverage at the most competitive price.

We are the recognized expert focusing
ONLY on Group Health Insurance.

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